This systematic review examines non-speaking tongue posture (NSTP) and its relationship to speech sound disorders (SSDs) and orofacial development, emphasizing assessment methods and reported associations. Following PRISMA (2020) guidelines, PubMed, Scopus, and Web of Science were searched during a defined window (October 2024–April 2025), yielding 265 records. Eligibility criteria permitted studies published from 2000 onward; the seven included studies were published between 2007 and 2022. After screening, seven studies involving pediatric and adult populations met inclusion criteria. Studies linking NSTP to SSDs or orofacial outcomes were included, whereas studies focused solely on dynamic tongue movement were excluded. Low or anterior NSTP was consistently associated with anterior open bite, crossbite, and articulation errors. Assessment methods varied, with clinical observation most common, while three-dimensional ultrasonography showed promise as a reliable, objective alternative. Overall, NSTP appears clinically relevant yet understudied, underscoring the need for standardized assessment tools and normative data.
Speech-language pathologists (SLPs) may design and implement public health approaches that advance children's language development. Universal, public health-informed SLP programmes could improve equity and access to SLP services for all children, including those from families that are historically underserved (e.g., socially and economically disadvantaged families). Social determinants of health, like food or housing insecurity, exposure to violence, or systemic inequalities (e.g., racism), may affect language development and also limit access to speech-language pathology services. This clinical focus article describes how a public health lens, trauma- and violence-informed care principles, and evidence about parent coaching in early language interventions were applied to develop a new programme titled Community Opportunities For Family Engagement and Empowerment, and Play and Learning Accessible for Youth (COFFEE and PLAY). The programme builds relationships between families and SLPs to (a) reduce barriers to service, (b) build parents' capacity to support children's language, and (c) promote school readiness.
Children with phonologically based speech sound disorders (SSDs) often experience difficulties in phonological perception, production, and awareness. Integrated intervention approaches address these domains simultaneously and promote links between phonology and orthography. The Fonolexis program, based on an integrated approach to the treatment of phonological disorder, was recently developed and validated for European Portuguese; however, evidence regarding its effectiveness in children with SSD is still limited. This study aimed to evaluate the effects of the Fonolexis program in preschool children with phonologically based SSD using a pre-post pilot design. Twelve preschool-age children (n = 12) received 24 intervention sessions delivered by the same speech-language therapist, organized into three blocks of eight sessions. Pre- and post-intervention assessments were conducted by another speech-language therapist. Outcome measures included percentage of correct consonants (PCC), occurrence of phonological processes, and phonological inventory. Results showed a substantial improvement in PCC (p = .002), a reduction in targeted phonological processes, an expansion of the phonological inventory, and generalization to untreated words. These findings support the positive effects of the Fonolexis program in preschool children with SSD.
While involvement of parents and peers as mediators or collaborators in intervention are evidence-based practices for autistic children, there is currently little research on how siblings of autistic children might be included in the intervention experience. In this exploratory study, autistic children who were verbal communicators participated with their siblings in a collaborative intervention experience that included co-construction of Comic Strip Conversations and the playing of a cooperative game. Fidelity of implementation was high across intervention sessions for the six sibling pairs. Caregivers valued the intervention as a context for supportive sibling interactions. Overall, children enjoyed the activities but would have liked a wider variety of activities and shorter sessions. Speech-language pathologists saw promise in intervention activities. The authors hope that this research will set the stage for further exploration of how clinicians might include siblings in the intervention experience of autistic children.
The purposes of this tutorial are twofold - first, to present data documenting elementary-aged children's production of complex syntax in language samples collected using the SUGAR (Sampling Utterances and Grammatical Analysis Revised) method of language sample analysis, and second, to offer step-by-step instructions detailing how to analyze a SUGAR language sample for complex syntax. The tutorial begins with a review of coordinate and subordinate clauses, supported by data documenting elementary-aged children's production of those structures. Next, a case study is presented to demonstrate how to use the SUGAR method to analyze a sample for coordinate and subordinate clauses. Sub-analysis of a SUGAR language sample can be used to assist SLPs with intervention planning. Specifically, SLPs can use sub-analysis when identifying appropriate intervention targets, tracking progress in therapy, and facilitating conversations with teachers and others regarding curriculum-relevance.
This study examined how symbol format (animated vs. static) and symbol set (Autism Language Program [ALP] vs. Picture Communication Symbols [PCS]) influence verb identification accuracy and symbol format preferences in 5- and 6-year-old children. Sixty-seven typically developing children were randomly assigned to one of four conditions in a 2 & times;2 factorial design. Trials used 16-symbol arrays, with animated conditions containing eight animated and eight static symbols. Format preference was assessed when both formats were present. No 2 & times;2 analysis of variance main effects emerged, but a significant interaction showed that static PCS symbols were identified more accurately than animated PCS. Results indicated that children preferred ALP animations over PCS animations and PCS static symbols over ALP static ones. While animation did not significantly improve overall identification accuracy, ALP animations outperformed PCS animations. Children preferred ALP animations, suggesting these may support symbol transparency and search efficiency in augmentative and alternative communication interventions.
Preschoolers with developmental language disorder may substitute object case pronouns in the subject position of sentences. This study explored whether pronoun case accuracy in spontaneous language samples was associated with the provision of personal pronouns in probes that use structural priming. Seventeen Head Start preschoolers participated. Two categorical measures were calculated based on the absence of spontaneous case errors in 15-min language samples and the presence of personal pronouns in responses to formal priming items on a standardized assessment. Children who produced spontaneous pronoun case errors were less likely to respond to priming with he, she, him, or her in subject position, instead producing lexical noun phrases such as "the boy." A prerequisite knowledge of English's case system may be needed for uptake of structural priming in standardized assessments. Preschoolers with immature pronoun case knowledge may not exhibit pronoun case errors during structured formal tasks that rely on priming cues.
This study evaluated the efficacy of an international tele-practice parent training program that is culturally and linguistically adapted from Improving Parents as Communication Teachers (ImPACT), a Naturalistic Developmental Behavioral Intervention (NDBI) program, among Chinese families with children with autism spectrum disorder (ASD). Six parents of 3- to 6-year-old Mandarin-speaking children with ASD in China completed the adapted tele-practice training delivered by Chinese clinicians residing in the United States. A single-subject multiple-baseline design was employed. Outcomes were evaluated through analyzing weekly parent-child play samples and the social validity questionnaire. Parents demonstrated improved fidelity of intervention implementation, mitigated use of directives, and reported reduced stress and greater availability of resources. Children showed longer mean length of utterance and higher percentages of spontaneous communication acts. The findings support using tele-practice to disseminate language-facilitating intervention internationally to a country with limited resources. Cultural and linguistic adaptations are essential to enhance outcomes.
This Scholarship of Teaching and Learning project examined 45 speech-language pathology graduate students' (G-SLPs) views about a 2 1/2 hr app literacy workshop. The curriculum focused on app features and the feature mapping process using past client cases within constructivist and personalized learning instructional formats. Inductive and deductive analyses of post-workshop written reflections indicated that these G-SLPs favorably rated the app workshop's andragogy, content, and relevance to preprofessional education. Students reported having gained knowledge about app characteristics, costs, and therapy applications, while also gaining app-related critical thinking skills. Results identified five significant student learning outcomes based on Fink's taxonomy (i.e., foundational knowledge, applications, integration, learning to learn, and human dimension). Findings also aligned with four entry-level professional standards for the Certificate of Clinical Competence in speech-language pathology. Implications are discussed for app literacy instruction among contemporary G-SLPs.
The purpose of this project was to explore the implementation of an inter-professional collaborative classroom-based book-making intervention with preschool children with developmental delays. The current study utilizes elements of an analytic autoethnography style, a qualitative ethnographic research method where it is typical for researchers to interact with the people they are researching in a deep, prolonged way to gain a rich understanding of the phenomenon they are studying. Results show that children with developmental delays transitioned through emergent writing stages and stages of narrative development, as well as developed a sense of agency as authors. The theoretical foundation for and results from this study suggest that a collaborative, classroom-based book-making intervention may benefit emergent writing, oral language, and writer/author agency for preschool children identified with developmental disabilities.
This pilot study examined the effectiveness of a bidirectional learning framework in bridging the gap between theoretical knowledge and clinical practice in speech-language pathology (SLP) education. The focus was on how students applied classroom learning to clinical settings and vice versa, and how this approach affected their clinical competence, critical thinking, and cultural awareness. A mixed-methods approach was used, with surveys, reflection journals, and grade performance from two SLP graduate cohorts (California and Texas) assessing students' confidence and competence. Results indicated both cohorts performed significantly well with improvements in students' ability to apply theory to clinical decision-making. Reflection journals further promoted critical thinking and self-reflection, with most students noting improved skills. The study suggests that bidirectional learning enhances clinical competence and professional development, fostering critical thinking, cultural competence, and lifelong learning, which are vital for effective SLP practice.
Children with developmental language disorder (DLD), a common disorder in childhood, experience a variety of difficulties across not only the components of language but also in areas such as executive functions. The aim of this study is to examine and compare the visual perceptual skills of children with typical development (TD) and DLD. A total of 60 children with TD (n = 30) and DLD (n = 30) between the ages of 4;0 and 6;0 were included in the study. The analyses revealed that the visual perception subtests and total test scores of the children with TD were significantly higher than those of the children with DLD, and that there was a positive significant relationship between language skills and visual perceptual skills of children with DLD. This study has concluded that the inclusion of visual perceptual skills in both the assessment and therapy processes of children with DLD may positively affect their development.
There is a paucity of descriptive research about written measures gleaned from writing samples that can be used to inform clinical practice. This exploratory study contributes data for writing measures obtained from informative paragraphs composed by fourth- and fifth-grade students with language-based learning disabilities (LLD). This study utilized a sample of convenience from a larger intervention study whereby assessments were obtained in the fall and spring of the same academic year. As part of the assessment battery, students composed two informative paragraphs using a scaffolded elicitation task across two informative writing prompts. Written transcription measures were compared between samples separately for each time point and correlations with oral language measures were evaluated. Findings indicated no significant differences in writing measures between prompts at either time point; however, correlations differed by prompt. These results contribute descriptive data about informative paragraph writing in a sample of students with LLD.
In this scoping review, we aimed to explore effective early language intervention strategies for culturally and linguistically diverse (CLD) populations. Guided by the PRISMA-ScR framework, we conducted searches in two electronic databases using specific inclusion criteria. An established coding framework was applied to assess the quality of the articles and to determine both the study quality indicators and the strength of the individual intervention strategies described. A total of 41 articles met the inclusion criteria. Based on quality indicators, 11 studies were classified as compelling , 9 as promising , and 21 as emerging . From these peer-reviewed sources, culturally responsive early language intervention strategies were charted and organized into seven domains. Thirty-eight impactful strategies that support the language development of young CLD children and their families were identified. Many sources emphasized caregiver engagement, culturally responsive language stimulation techniques, and narrative-based methods, all of which support natural, culturally rich learning environments.
The current study aimed to examine students’ use of morphologically complex words in writing in relation to performance on other language tasks. In this study, language-learning data were collected on 490 students in fifth-grade classrooms. Measures included morphologically complex word (MCW) use in expository writing, decomposition and nonword derivation tasks, and general vocabulary and reading comprehension. There were significant small to moderate positive correlations between written MCW use and performance on decomposition and nonword MK tasks for students without developmental language disorders. For students with a developmental language-learning disorder (DLD), written MCW use was significantly correlated with decomposition skills. The measures of interest accounted for 18.34% of the variance in student MCW use, with the decomposition task as the only variable contributing unique variance.
Retrieval practice involves actively recalling information from memory and has been found to be an effective strategy for word learning. This case study aimed to describe the effect of retrieval practice on word learning in four children who are deaf or hard of hearing (DHH). Children received eight language intervention sessions in 4 weeks. Target words were presented in the context of a narrative under three different conditions: no retrieval, immediate retrieval, or spaced retrieval. Under the no-retrieval condition, children received exposure to new words, but they were not asked to recall them. Under the immediate-retrieval condition, children were required to recall words immediately after exposure. Under the spaced-retrieval condition, children had to recall words some time after exposure. In addition, words were probed but not taught under a control condition. We measured word learning before, during, and after the intervention. We found that children learned target words under the intervention conditions but not under the control condition. Three out of four participants remembered more words under the spaced- and immediate-retrieval conditions than under the no-retrieval condition, suggesting that explicit and active practice contributes to learning more than passive exposure to words. The narrative intervention provided a natural context for teaching vocabulary, which can be implemented in both clinical and educational settings.
Familial beliefs and abilities play a crucial role in shaping the dynamics of shared book reading between caregivers and their young children. The variations in caregiver shared book reading behaviors significantly impact what and how much a child learns from those experiences. Thus, understanding caregiver beliefs through a strength-based lens is essential to inform the development of resources, recommendations, and interventions that prioritize familial perspectives. This approach is crucial for promoting children's development, especially in vulnerable communities like migratory families and families experiencing homelessness. Therefore, this qualitative study adopted a strengths-based approach to explore the shared book reading perspectives, practices, and strengths in migratory and unhoused families. Through interviews with 13 caregivers (6 migratory caregivers and 7 unhoused caregivers), a phenomenological analysis revealed key themes of Shared Book Reading as Protection, Shared Book Reading as a Bridge, Reading to Teach, Making Reading Interesting, and Following the Child's Lead. The paper concludes with a discussion of how the themes can serve as a foundation for the development of future shared book reading resources and interventions in collaboration with migratory and unhoused families, promoting inclusivity and effectiveness by aligning resource development with their unique perspectives and strengths.
Speech sound disorder (SSD) is one of the most common communication disorders in children, often requiring high-dosage treatment for remediation. Limitations including clinician time constraints and large caseloads highlight the need for innovative service delivery models to expand treatment access. This study examined the effectiveness of a hybrid model that incorporated parent training and home practice, compared with a telepractice only approach. Twenty-two children with SSD were randomly assigned to one of two groups: a business-as-usual group receiving twice-weekly telepractice sessions, or a parent training group receiving once-weekly telepractice, with parents participating in online training and home practice. All sessions used a Speech Motor Chaining approach. Both groups showed significant improvements in speech sound accuracy from pre- to posttreatment, maintained at a 2-month follow-up, with no significant differences between groups. Findings suggest that a hybrid model involving parent training and home practice may be a viable alternative to high-frequency therapy.
This case report describes a decoding intervention that was developed for and implemented with a 15-year-old female with significant word-level reading challenges. The intervention integrated multiple evidence-based approaches to improve decoding, including instruction in (a) phonemes-graphemes (sounds-symbols) that the participant did not know at pre-test, (b) high-frequency morphemes, and (c) flexible syllabication. In addition to this, midway through the nine-session intervention, reading fluency opportunities were introduced through non-repetitive reading fluency practice with researcher feedback. Post-test assessments revealed improvements across all measures compared with pre-test scores including on oral and written language, decoding, spelling, sound-symbol knowledge, reading level, self-concept as a reader, and self-efficacy in reading. Particularly noteworthy was her growth of 1.5 standard deviations on a standardized decoding measure, two standard deviations on sound-symbol knowledge, and five grade-levels of her reading level. This intervention demonstrates promise as an efficacious and efficient way to treat adolescents’ decoding skills.
This study examined the self-perceived confidence and preparedness of 128 certified speech-language pathologists (SLPs) and 26 SLP graduate students in Wisconsin when serving bilingual children. Participants, monolingual or bilingual, completed an online survey. The relationship between confidence, preparedness, academic coursework, and continuing education was investigated. Results indicated that bilingual SLPs show higher confidence and preparedness levels than monolingual SLPs when working with bilingual children. However, both groups exhibited significantly higher confidence and preparedness when working with monolingual children. A regression analysis revealed that the number of continuing education courses (CEUs) significantly predicts confidence and preparedness levels for working with bilingual children. In contrast, the number of academic coursework topics covered did not significantly correlate with confidence or preparedness. The results highlight the need for specialized learning opportunities that focus on the complexities of bilingual service provision in improving the readiness of both monolingual and bilingual SLPs, and graduate students to serve bilingual populations effectively.
